CN106132475A - Insertion type medical system, instrument and sub-component - Google Patents
Insertion type medical system, instrument and sub-component Download PDFInfo
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- CN106132475A CN106132475A CN201580017477.3A CN201580017477A CN106132475A CN 106132475 A CN106132475 A CN 106132475A CN 201580017477 A CN201580017477 A CN 201580017477A CN 106132475 A CN106132475 A CN 106132475A
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- tie
- component
- length section
- delivery
- elongated tubular
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/0587—Epicardial electrode systems; Endocardial electrodes piercing the pericardium
- A61N1/059—Anchoring means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/056—Transvascular endocardial electrode systems
- A61N1/057—Anchoring means; Means for fixing the head inside the heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/37205—Microstimulators, e.g. implantable through a cannula
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/375—Constructional arrangements, e.g. casings
- A61N1/3756—Casings with electrodes thereon, e.g. leadless stimulators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/056—Transvascular endocardial electrode systems
- A61N1/057—Anchoring means; Means for fixing the head inside the heart
- A61N2001/0578—Anchoring means; Means for fixing the head inside the heart having means for removal or extraction
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- Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Prostheses (AREA)
Abstract
A kind of tie-down sub-component that can be used by the instrument disposing implantable medical device includes for verifying the described device the most fixing test section at implant site.When described device is located close at the distal openings of pipe, tie-down the first length section extends through the attachment structure of described device and in the elongated tubular of instrument, tie-down the second length section and tie-down the first length section extend abreast in pipe, and described test section is located close at distal openings.Test section is constructed such that be applied only to tie-down the first length section and test section just can be pulled through more than or equal to the power of pullling of predetermined power the aperture of means of delivery or described device.Predetermined power is corresponding to the minimum fully bed knife of described device.
Description
Technical field
The present invention relates to insertion type medical system, and relate more specifically to the implantable medical dress of beneficially relative compact
The percutaneous put, instrument and the sub-component thereof of disposing and fix checking through vein.
Background technology
Traditional implantable cardiac pacemaker includes the pulse generation being connected to the lead-in wire of one or more flexible elongate
Device.This device is typically implanted into away from the subcutaneous pocket of heart, and each in the one or more lead-in wire is from this
Device extends to counter electrode, and this electrode is positioned in pacing site (endocardium or visceral pericardium) place.Sometimes with elongated leads phase
The mechanical complications of association and/or MRI compatible sex chromosome mosaicism have promoted the development of implantable pacemaker, this device quilt
So that next-door neighbour's pacing site (such as, in the right ventricle RV of heart) implants in being fully accommodated in the packaging of relative compact.Reference
Figure 1A-1B, it is shown that such device 200, the most preferably by biocompatibility and the metal shape of Biostatic of such as titanium
The shell 205 of the gas-tight seal become comprises pulse generator or electronic controller (not shown), and at least one electrode 211 is the most logical
Cross the airtight feed-through component (not shown) known to the technical staff in implantable medical device field be connected to this pulse generator or
Electronic controller.Shell 205 can be by the insulating barrier cladding of such as medical grade polyurethane, Parylene or silicones.
Figure 1A shows device 200, at the target site 150 in the tip of this device implanted such as right ventricle RV, and by
Fixing component 215 is secured in place, and fixing component 215 includes the multiple pointed tooths being more clearly visible that in fig. ib.The fixing structure of diagram
The embodiment of part 215 is described in commonly assigned U.S. Patent application 2012/0172690, and this application is with way of reference in full
It is incorporated herein.Figure 1A also illustrates that what distal part from the elongate delivery instrument 100 of for example, guiding catheter disposed out
Device 200, this elongate delivery instrument passes through postcava IVC according to method known to Interventional cardiology field to upper-pilot
And enter right ventricle RV from right atrium RA.
Fig. 2 A-2B is that instead of the plane graph of the specific purpose tool 300 of the more common catheter type instrument of similar means 100, should
Specific purpose tool is developed for disposing the implantable medical device of the relative compact being similar to device 200.Fig. 2 A-2B shows instrument
300, it includes that shank assembly 310, outer tube 330 and the core 350 of such as inner elongated tube that extends in outer tube 330 are (at Fig. 2 A
In shown in broken lines).Fig. 2 A-2B also illustrates that the outer tube 330 including farthest side part 332, and farthest side part 332 is dimensioned to
Comprising implantable medical device (such as, above-mentioned device 200), this device can be seen in the sectional view cut open of Fig. 2 B, this
Time device the distal member 352 of the adjacent core/pipe 350 of near-end (such as, attachment structure 222).Outside farthest side part 332 also limits
The distal openings 303 of pipe 330, when such as by moving the control member 312 of shank assembly 310 and by outer tube 330 along arrow B
Along arrow b recall relative to core/pipe 350 or bounce back time, device 200 is deployed and by this distal openings, such as such as Fig. 2 B
Shown in.With further reference to Fig. 2 A-2B, shank assembly 310 includes another control member 311, and the near-end of wire drawing (not shown) can
To be attached to this control member；The far-end of wire drawing can be anchored near the distal member 352 of core/pipe 350 so that when controlling structure
Part 311 along arrow A move time, instrument 300 along arrow a deflect, as shown in Figure 2 B.Deflection along arrow a can be favourable
Position in farthest side part 332 is close to target site 150 so that when outer tube 330 bounces back along arrow b, fixing component 215
Above-mentioned pointed tooth can engage with the tissue at position 150.It is included in commonly assigned U.S. Patent application 2013/0103047
In disclosure describe the ordinary construction of instrument of similar means 300, the disclosure is incorporated herein by reference.
Referring again to Figure 1A, the attachment structure 222 that tie-down 140 is shown as from device 200 extends and back into work
In tool 100 so that the portions of proximal of the outward extending tie-down of near-end 140 from instrument 100 is palp for operator.
With reference to Figure 1B, attachment structure 222 includes eyelet 202, tie-down 140 can around by this eyelet so that device 200 is temporarily solid
Surely tie-down 140 is arrived.When during device 200 is loaded into instrument 300 to dispose, tie-down 140 can be fixed similarly
To device 200.With reference to Fig. 2 A-2B, ring-type tie-down 140 extends in core/pipe 350 so that the end of tie-down 140 is from core
The proximal open 351 of 350 extends, and there, operator can pull tie-down 140 with test device 200 at implant site
Fixing situation, and when necessary bigger power is applied to tie-down 140, to be removed from implant site by device 200, in order to
It is repositioned at more suitably position.If operator is illustrating the satisfaction of the performance at implant site to device 200, operator can
To discharge tie-down 140 from attachment structure 222 and to make tie-down 140 recall through means of delivery 300.
Summary of the invention
Because the operator performing simply to pull such as above test not necessarily knows that the great power of applying is come
Fully fixing of the device that checking is implanted, and because the power of pullling applied is not necessarily identical for different operators
, so needing the embodiment of insertion type medical system disclosed herein, it is configured to provide and fills implantable medical
Put the most fixing calibrated test of pullling at target implantation site to verify.According to some embodiments, means of delivery is adopted
With the tie-down sub-component included for verifying the most fixing test section, this means of delivery is configured to beneficially dispose
Implantable medical device so that its fixing component engages with tissue at implant site.When medical treatment device is in order to be disposed by instrument
And when being located close at the distal openings of the elongated tubular of instrument, tie-down the first length section extend through device attachment structure and
In pipe, tie-down the second length section and the first length section extend in pipe abreast, and the test section of tie-down sub-component
Section is located close at the distal openings of pipe.Test section is configured to so that be only applied through the first length of tie-down sub-component
Spend section and just the test section of tie-down sub-component can be pulled through aperture more than or equal to the power of pullling of predetermined power, wherein, hole
Mouthful or be included in means of delivery (passage of such as elongated tubular) or include (such as, the hole of attachment structure in a device
Eye).Predetermined power is corresponding to the most solid with the minimum engaging offer of the tissue at implant site by the fixing component of device
Determine power so that if test section is not made device separate by pullling power and being pulled through aperture by operator, then operator can be sure that
Device is sufficiently immobilized on implant site.
According to some embodiments, the near-end of the first length section of above-mentioned tie-down is opened from the nearside of the elongated tubular of means of delivery
Mouth proximad extends so that operator applies to pull by capturing the first length section of the tie-down of the near-end near tie-down
Power.According to some alternatives, means of delivery includes joint, and this joint is by the near-end of the first length section of tie-down regularly
It is attached to the elongated tubular of instrument so that operator can apply to pull power by capturing pipe.
Accompanying drawing explanation
Following figures illustrate only certain embodiments of the present invention, and therefore do not limit the scope of the invention.Accompanying drawing is not pressed
Ratio draws (unless so explanation) and the explanation that is intended in by the following specific embodiment uses.Below in conjunction with
Accompanying drawing describes each embodiment, and in the accompanying drawings, identical label represents identical element, and:
Figure 1A shows the schematic diagram of the exemplary implantable medical device of implantation；
Figure 1B is the plane graph of example medical device；
Fig. 2 A is the plane graph of exemplary delivery instrument；
Fig. 2 B is the plane graph of exemplary insertion type medical system, and this system includes the instrument of Fig. 2 A and the device of Figure 1B；
Fig. 3 A is the plane graph of the tie-down sub-component according to some embodiments of the present invention；
Fig. 3 B is a part for the system of Fig. 2 B of the tie-down sub-component that have employed Fig. 3 A according to some embodiments
Plane graph, this plane graph includes the sectional view cut open；
Fig. 3 C is the plane graph of the part of the insertion type medical system according to some alternatives, and this figure includes section view
Figure；
Fig. 4 is another plane graph of the system of Fig. 3 C according to some embodiments；
Fig. 5 A is the plane graph of the part of the insertion type medical system according to some additional embodiment, and this figure includes section view
Figure；And
Fig. 5 B is the plane graph of the tie-down sub-component according to some alternatives, and this figure includes partial sectional view.
Detailed description of the invention
Described in detail below is exemplary in itself, and be not intended to limit by any way the scope of the present invention,
The suitability or configuration.On the contrary, following description provides practical example, and those skilled in the art is it will be recognized that in example
Some can have suitable alternative.Although additionally, exemplary embodiment is providing the insertion type medical treatment of cardiac treatment
Describe under the background of system, but the scope of the present invention can contain the system being applicable to other type of therapeutic treatment.
Fig. 3 A is the plane graph of the tie-down sub-component 400 according to some embodiments of the present invention；And Fig. 3 B is medical treatment
The plane graph of a part for interventional systems, it includes the sectional view cut open, wherein, according to some embodiments, tie-down sub-component
400 combine means of delivery 300 (Fig. 2 A-B) uses.Fig. 3 A shows tie-down sub-component 400, and it includes that one or more is thin
Long stapled first length section 41B and the second length section 42B and between the first length section 41B and the second length section 42B
Test section 420.Fig. 3 B shows the attachment structure 222 of the device 200 of the distal member 352 being adjacent to pipe 350, attachment knot
In the distal openings 305 of the distally located component of structure 222 352, and tie-down 400 is fixed to device 200, and tie-down provisionally
The first length section 41B of 400 extends through the aperture formed by the eyelet 202 of attachment structure 222, and the of tie-down 400
Two length section 42B and the first length section 41B extend abreast in pipe 350.Although it is not shown, but pipe 350 can be many tube chambers
Pipe, it has separate tube chamber to accommodate the first length section 41B and the second length section 42B of tie-down 400.Fig. 3 B also show
First length section 41B of tie-down 400 and the near-end of the second length section 42B, it is outside from the proximal open 351 of pipe 350
Extend, thus can be touched by operator.First length section 41B and the second length section 42B passes freely through and is formed by eyelet 202
Aperture, but according to diagram embodiment, the test section 420 of tie-down sub-component 400 is configured only to by more than or equal to predetermined
The power of pullling of power be pulled through eyelet 202 along arrow P, this is pullled power and is such as applied to the first length section 41B along arrow T,
Wherein, the minimum fully bed knife of the predetermined power device 200 corresponding to such as being provided by fixing component 215.
Referring again to Fig. 2 B, as it has been described above, handle instrument 300 operator to pass through outer tube 330 to be disposed by device 200
Distal openings 303 so that the pointed tooth of fixing component 215 at position 150 with organize and engage after, operator can capture and fasten
The near-end of part the first length 41B also performs to pull test by applying the above-mentioned power of pullling along arrow T, to evaluate the point engaged
The fixing situation of tooth.If device 200 is not sufficiently immobilized at position 150, then the power of pullling applied will make fixing component
215 engage separates and test section 420 is not pulled through the eyelet 202 of device attachment structure 222；But, if power of pullling will
The test section 420 of tie-down sub-component 400 is pulled through eyelet 202 and does not make fixing component 215 separate, then operator can be sure that dress
Put 200 to be sufficiently immobilized at position 150.According to some embodiments, the test section 420 interference fit in eyelet 202
(such as, the magnitude of interference of about 0.001 inch) guarantees that the power of pullling applied only is sufficiently immobilized on position 150 at device 200
During place, test section 420 is pulled through eyelet 202.Sufficient bed knife for device 200 can be about 1.5 newton.
Any suitable biocompatible fibres (such as, has the polyester fiber of the fluoropolymer coating of such as PTFE)
The first length section 41B and the second length section 42B of tie-down 400 can be formed, and test section 420 can be by such as gathering
Ether-amide block is (such as,3533 or 4033), the biocompatible polymeric material shape of silicones or polyurethane
Become.According to some exemplary embodiments, test section 420 is positioned in around the single elongated fibers of tie-down sub-component 400,
And it is fixedly coupled in the position making the first length section 41B and the second length section 42B of tie-down sub-component 400 separate
This fiber.Such as, test section 420 can be by insert moulding at fiber peripheral, or test section 420 could be formed with logical
Hole, the fiber of tie-down 400 is threaded by this through hole and the most such as utilizes any suitable biofacies known in the art
Capacitive binding agent and be incorporated therein.Form material (such as, the polyurethane or above-mentioned of test section 420In material
One) can be blended, so that the outer surface of test section 420 is more smooth with another kind of material (such as, the siloxanes of 10%).
According to some embodiments, test section 420 can not be saturating for ray so that operator can be supervised by cryptoscopy
(such as, the eyelet 202 of device attachment structure 222, it is also preferably ray relative to the aperture of system to survey test section 420
Can not be saturating) position.Therefore, the material forming test section 420 is (such as, above-mentionedMaterial) can with ray not
Permeable material (such as, 40% barium sulfate (BaSO4) or bismuth subcarbonate) is blended.Can not be saturating if test section 420 is not ray
, operator may rely on the lax or tension force of tie-down the first length section 41B during pullling test and reduces as pullling
Test section 420 has been pulled through the instruction of eyelet 202 by power.
In conjunction with Fig. 3 C with further reference to Fig. 3 A, tie-down sub-component 400 can the alternative enforcement of alternatively combination tool 300
Example uses.Fig. 3 C is portions of proximal and the plane graph of distal part of insertion type system, and has the means of delivery through system
The sectional view of far-end.Diagram means of delivery is with the difference of above-mentioned instrument 300: replace pipe 350 to extend in outer tube 330
Core/elongated tubular 350C includes the passage 357 being located close at the distal openings 305C of this pipe, wherein, the distal member of pipe 350C
352C can limit distal openings 305C.According to diagram embodiment, passage 357 forms the aperture of system, tie-down sub-component 400
Test section 420 only can be pulled through this aperture more than or equal to the power of pullling of above-mentioned predetermined power along arrow T.According to some
Embodiment, the test section 420 interference fit (such as, the magnitude of interference of about 0.001 inch) in passage 357 guarantees to be applied
Power of pullling only when device 200 is sufficiently immobilized on implant site, test section 420 is pulled through passage 357.Fig. 3 A and figure
3C shows and includes the first length section 41C and the tie-down sub-component 400 of the second length section 42C, wherein, the second length section 42C
Extend between the first length section 41C and test section 420.When tie-down 400 is interim by the attachment structure 222 of device 200
When fixing, and when test section 420 is positioned in passage 357 nearside (as shown in the figure) to be attached provisionally by device 200
During to means of delivery, tie-down the first length section 41C and the second length section 42C extends in pipe 350C the most abreast.According to
Diagram embodiment, pipe 350C is multitube lumen, and it has: the first tube chamber 301, at least the first length section 41C and the second length section
42C can pass freely through wherein；With the second tube chamber 302, the most constrained part forms passage 357.Fig. 3 C also show and fastens
The near-end of tie member the first length section 41C, it stretches out from proximal open 351C of the pipe 350C near shank assembly 310, makes
Obtain operator and can be applied to tie-down by pullling power along arrow T.
According to some embodiments, the tie-down sub-component 400 as used in pipe 350C may also include the 3rd length section 43C
(the most shown in broken lines), it extends from test section 420 proximad and passes proximal open 351C of pipe 350C out.
Alternatively, optional 3rd length section 43C can be relatively short so that the 3rd length 43C is only at the diagram extremity of instrument
Extend in point.But, optional 3rd length section 43C can be with long enough so that the 3rd length section 43C is near proximal open
At 351C accessible for operator, even also such after pullling test execution, test section 420 is pulled through logical by this test
Road 357 (such as, as shown in Figure 4) is to verify the most fixing of device 200.With reference to Fig. 4, the power along arrow R can be applied in
To tie-down the 3rd length section 43C, then tie-down test section 420 is drawn rearwards over the logical of inner tube 350C along arrow L
Road 357, thus re-form the temporary attachment between device 200 and means of delivery, as shown in Figure 3 C.Interim re-forming
After attachment, such as, by be enough to make device to fix power tractive tie-down the first length section 41C that component 215 disengages and the
Three length section 43C, then advance (such as, by making shank group along arrow C on the device 200 backward by the outer tube 330 of instrument
The control member 312 of part 310 moves up in the side relative with the direction by the shown by arrow B in Fig. 2 B), device 200 is permissible
It is removed for being repositioned at another implant site from implant site 150.
The first length section 41C and the second length section 42C of the tie-down 400 as employed in the instrument of Fig. 3 C and Fig. 4 with
And optional 3rd length section 43C can be formed by any suitable biocompatible fibres described above, wherein, test section
420 are formed also according to any one in above-described embodiment.The tube chamber 302 of pipe 350C and passage 357 can be by such as inserting structure
Part is formed, and this insertion component is by such asThe biocompatible polymer material of 3533 or 4033, silicones or polyurethane
Material is formed, and is fixedly attached to the wall of pipe 350C, and wherein, the remainder of pipe 350C can be by the material shape being similar to
Become.The insertion component that may also comprise the first tube chamber 301 can mould individually, is then re-incorporated into wall (such as, the root of pipe 350C
Combined by thermal or binding agent according to methods known in the art).Alternatively, inserting component can be with the wall inserts of pipe 350C
It is molded over together.If the test section 420 of tie-down sub-component 400 can not be saturating for ray, and if inserting component
Passage 357 is also formed by ray not permeable material (such as, being similar to the material described above with respect to test section 420), then
Operator can come the monitoring and test section 420 position relative to passage 357 by cryptoscopy.Alternatively, if
Passage 357 is not that ray can not be saturating, then distal member 352C of pipe 350C can be that ray can not be saturating, so that operator
Test section 420 that ray can not the be saturating position relative to distal member 352C can be monitored.Therefore, survey is being pullled as operator
See, by cryptoscopy, distal member 352C that test section that ray can not be saturating 420 and ray can not be saturating during examination
During merging, operator is believed that test section 420 has been pulled through the passage 357 of distally located component 352C nearside by the power of pullling.
According to exemplary embodiment, distal member 352C (such as, is blended with BaSO4 by ray not permeable material
7033) formed, and separated before being attached to the remainder of pipe 350C.If test section 420, passage 357 and remote
Side member 352C is not the most that ray can not be saturating, then operator may rely on tie-down the first length section during pullling test
Lax or the tension force minimizing of 41C is used as power of pullling and test section 420 has been pulled through the instruction of passage 357.
Fig. 5 A is portions of proximal and the plane graph of distal part of another embodiment of insertion type system, and have through
The sectional view of the far-end of the means of delivery of system.The elongated tubular 550 that the means of delivery of diagram extends in being included in outer tube 330；And
And it being similar to pipe 350C shown in Fig. 3 C, pipe 550 includes the passage 357 being located close at the distal openings 505 of pipe 550.Work as survey
When examination section 420 is positioned at passage 357 nearside so that provisionally device 200 is attached to means of delivery, the first tie-down length section 41C
Also extend the most abreast in pipe 550 with the second tie-down length section 42C.But, the instrument of Fig. 5 A and work shown in Fig. 3 C
The difference of tool is: pipe 550 includes the joint 54 such as being combined by binding agent and/or being formed by interlock fit, and this joint will
The near-end 401 of tie-down the first length section 41C is fixedly attached to pipe 550.Therefore, it not along arrow T by the above-mentioned power of pullling
It is applied directly to tie-down the first length section 41C, but is such as attached regularly by crawl tractive pipe 550 by operator
Shank assembly 310 or by capturing and directly tractive, near the portions of proximal of the pipe 550 of shank assembly 310, will pull power
It is applied to pipe 550.According to some embodiments, pipe 550 includes the distal member 552 limiting distal openings 505, and test section
420 and distal member 552 can not be saturating for ray.Therefore, as described above for described by the instrument of Fig. 3 C, operator can be
Come the monitoring and test section 420 position relative to distal member 552 by cryptoscopy during pullling test, and work as
Operator sees that when the distal member 552 that test section 420 that ray can not be saturating can not be saturating with ray merges, operator can be true
Letter is pullled power and test section 420 has been pulled through the passage 357 of distally located component 552 nearside.Fig. 5 A also show and optionally fastens
Tie member the 3rd length section 43C, it extends from test section 420 proximad and from the proximal open 551 of pipe 550 out, wherein, the
Three length section 43C can use in the way of being similar to above in association with Fig. 4 description.
In conjunction with Fig. 5 B with further reference to Fig. 5 A, the first tube chamber 301 of pipe 505 and the second tube chamber 302 including passage 357 can
To be formed by insertion component, it is similar to above in association with described in Fig. 3 C.Fig. 5 B shows such insertion component 67, root
According to some alternatives, this insertion component and tie-down sub-component 400 are bonded together to form another tie-down subgroup
Part 600, wherein, after being joined to tie-down the first length section 41C insert component 67, inserting component 67 can be such as according to this
Method known to field combines the wall being fixedly attached to pipe 550 by thermal or binding agent.According to some embodiments, tube chamber
The surface of 301 is such as combined by binding agent and/or insert moulding adheres to the near-end of tie-down the first length section 41C regularly
401, to form above-mentioned joint 54.Alternatively or additionally, joint 54 is included in the near-end 401 of tie-down the first length section 41C
And the mechanical interlock inserted between the first tube chamber 301 of component 67, the most as shown in Figure 5 B.
In foregoing detailed description, describe the present invention with reference to specific embodiment.However, it is to be appreciated that without departing from
In the case of the scope of the present invention illustrated in claims, various modifications and changes can be carried out.
Claims (12)
1. an insertion type medical system, including implantable device and be conducive to disposing the means of delivery of described implantable device,
Described device includes that attachment structure and fixing component, described fixing component are configured to joint tissue at implant site；And
Described means of delivery includes:
Elongated tubular, described elongated tubular extends to the distal openings of described elongated tubular from the proximal open of described elongated tubular；And
Tie-down sub-component, described in tie part sub-component and include the first length section, the second length section and test section, when described dress
Setting in time at the described distal openings of described pipe, described first length section extends and through described in described elongated tubular
The described attachment structure of device, described second length section and described first length section extend abreast in described pipe, and described the
One and second length section be each configured to pass freely through the aperture of described system, described test section is located close to described pipe
At described distal openings, and described test section is configured only to be pulled through institute by the power of pullling more than or equal to predetermined power
State the described aperture of system, described in pull power and be applied to described first length section of described tie-down sub-component, and described
Predetermined power is filled corresponding to the minimum provided by the joint of described fixing component with the described tissue at described implant site
Divide bed knife；And
Wherein, the described aperture of described system includes one of having structure: the eyelet of the described attachment structure of described device, described
Described first length section of tie-down sub-component extends through described eyelet；And be positioned at described instrument described elongated tubular,
Passage at the described distal openings of described pipe.
System the most according to claim 1, it is characterised in that described first length section of described tie-down sub-component near
The described proximal open from the described elongated tubular of described means of delivery is held to stretch out towards nearside.
3. according to the system described in any one in claim 1 to 2, it is characterised in that described means of delivery also includes joint,
The near-end of described first length section of described tie-down sub-component is fixedly attached to described elongated tubular by described joint.
4. according to the system described in any one in claims 1 to 3, it is characterised in that:
Described second length section of the described tie-down sub-component of described means of delivery is described the of described tie-down sub-component
Extend between the described test section of one length section and described tie-down sub-component；And
The described aperture of described system includes the described passage of the described elongated tubular of described instrument.
5. according to the system described in any one in Claims 1-4, it is characterised in that described tie-down sub-component described
The near-end of the first length stretches out towards nearside from the described proximal open of described elongated tubular.
6. according to the system described in any one in Claims 1-4, it is characterised in that described means of delivery also includes joint,
The near-end of described first length section of described tie-down sub-component is fixedly attached to described elongated tubular by described joint.
7. according to the system described in any one in Claims 1-4, it is characterised in that fasten described in described means of delivery
Part sub-component also includes that the 3rd length section, described 3rd length section extend through from the described test section of described tie-down sub-component
Cross the described elongated tubular of described instrument and go out from the described proximal open of described pipe.
8. according to the system described in any one in Claims 1-4, it is characterised in that described means of delivery described elongated
Pipe is multitube lumen, and described first length section of the described tie-down sub-component of described instrument prolongs in the first tube chamber of described pipe
Stretching, described second length section of described tie-down sub-component extends in the second tube chamber of described pipe, and described passage is positioned at
In described second tube chamber.
9. according to the system described in any one in Claims 1-4, it is characterised in that described means of delivery also includes attachment
To the insertion component of the wall of described elongated tubular, described insertion component includes being formed at described passage therein.
10. according to the system described in any one in Claims 1-4, it is characterised in that:
The described elongated tubular of described means of delivery also includes the distal member limiting the described distal openings of described elongated tubular, described
Distal member is that ray can not be saturating, and the described passage of described pipe is positioned at described distal member nearside and be not that ray can not
Saturating；And
The described test section of the described tie-down sub-component of described means of delivery is that ray can not be saturating.
11. according to the system described in any one in claim 1 to 10, it is characterised in that:
The described test section of the described tie-down sub-component of described means of delivery is positioned at described the of described tie-down sub-component
Between one length section and described second length section of described tie-down sub-component；And
The described aperture of described system includes the described eyelet of the described attachment structure of described medical treatment device.
12. according to the system described in any one in claim 1 to 12, it is characterised in that fasten described in described means of delivery
The described test section of tie member sub-component is that ray can not be saturating.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US14/231,976 US9861815B2 (en) | 2014-04-01 | 2014-04-01 | Interventional medical systems, tools, and subassemblies |
| US14/231,976 | 2014-04-01 | ||
| PCT/US2015/023278 WO2015153421A1 (en) | 2014-04-01 | 2015-03-30 | Interventional medical systems, tools, and subassemblies |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN106132475A true CN106132475A (en) | 2016-11-16 |
| CN106132475B CN106132475B (en) | 2018-11-02 |
Family
ID=52823878
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201580017477.3A Active CN106132475B (en) | 2014-04-01 | 2015-03-30 | Insertion type medical system, tool and sub-component |
Country Status (4)
| Country | Link |
|---|---|
| US (1) | US9861815B2 (en) |
| EP (1) | EP3125995B1 (en) |
| CN (1) | CN106132475B (en) |
| WO (1) | WO2015153421A1 (en) |
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Also Published As
| Publication number | Publication date |
|---|---|
| US20150273207A1 (en) | 2015-10-01 |
| EP3125995A1 (en) | 2017-02-08 |
| EP3125995B1 (en) | 2018-05-16 |
| US9861815B2 (en) | 2018-01-09 |
| CN106132475B (en) | 2018-11-02 |
| WO2015153421A1 (en) | 2015-10-08 |
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